Speaking as a former ER Tech and medical student, doctors are the most likely to just "forget" to bill for the random bullshit that admin wants tracked to an obscene degree. There are some ERs (mostly HCA run ones) that have to scan your patient barcode and the cabinet to track giving you an ice pack. I've really only worked in community hospitals and intend to keep it that way, and doctors are the most likely member of a care team to just do whatever is necessary and fail to document it. I've also seen doctors down-code visits and procedures to make it easier to get insurance to pay for things.

PS: I'm intending to go into emergency medicine and/or critical care at community safety net hospitals or critical access hospitals and I will raise hell to increase the number of social workers in the department to help patients get the resources they need.

[–] ToastyMedic@reddthat.com 3 points 1 year ago (1 children)

When I was a unit clerk for an ICU unit, I was taught an "optional" part of the job which was basically me billing patients for "missed" (doctor forgot to bill for, intentionally) services and procedures.

Suffice to say I intentionally didn't do that part of my job. Glad I'm off to x-ray where we've got 2 steps of detachment from that crap.

[–] medgremlin@lemmy.sdf.org 2 points 1 year ago

I was on a different side of that equation when I was a clinic assistant in a surgery practice. A decent chunk of my job was fighting with insurance companies to get them to cover medically necessary procedures. It was a plastic surgery practice that was part of an oncology group, so one of the surgeons mostly did melanoma surgery and the other mostly did breast reconstruction after mastectomy, and they both did some cosmetic and general plastic surgeries here and there. The insurance companies would do idiotic things like not need a formal prior authorization for a melanoma excision, but because the skin graft needed to repair the excision site technically counted as a "plastic surgery" by its CPT code, they would require a prior authorization for that.

One of my favorite things is when I got the insurance companies to cough up for medically necessary panniculectomies following drastic weight loss which heavily subsidized the "upgrade" to a tummy tuck/full abdominoplasty. The patient basically just had to pay the difference instead of paying for the whole thing. Our surgeons were really good at planning and coding procedures like that to help patients as much as possible.

[–] Franzia@lemmy.blahaj.zone 2 points 1 year ago

Thank you! I thought this was likely the case but now I'm certain. Your career choice sounds deeply noble. And meaningful, fun.